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EDITORIAL: States launch another harmful attack on the Affordable Care Act

Star Tribune (Minneapolis, MN)

June 14--Roughly 335,000 Minnesotans access private and public health coverage with the help of the Affordable Care Act (ACA). Regrettably, three neighboring state attorneys general are working to boot them -- and thousands of people in the three states -- off their current health plan while at the same time trying to take away the financial aid that reduces premium costs.

The fevered dream of eradicating the ACA has become a political zombie -- it just won't die even though Republicans have tried and failed to do so for nearly a decade. The lawsuit that North Dakota, South Dakota and Wisconsin have joined is simply the latest of these tiresome assaults on former President Barack Obama's 2010 signature health care law.

Often referred to as the "Texas case" because the Texas attorney general has taken the lead, the suit seeks to unravel the ACA. It contends that the law is no longer constitutional because Congress voted late last year to effectively end the individual requirement to have health insurance.

Texas has been joined by North Dakota, South Dakota, Wisconsin and 16 other states. The lawsuit's foundation has garnered a drubbing from legal experts and drawn an aggressive challenge from 16 other states -- a list that thankfully includes Minnesota. Due to the stately pace of the court system, this case will likely take time to resolve. The lawsuit was filed Feb. 26, but generated headlines recently when it became clear that the U.S. Department of Justice is departing from institutional tradition by failing to adequately defend the law.

In the meantime, it is important to understand the stakes involved, especially during an election year. If courts eventually buy the case's reasoning, then it is goodbye to the ACA components that have helped a lot of people. Among them: the premium assistance subsidies, the expanded eligibility for the publicly-run Medicaid program and the provision allowing young adults to stay on their parents' health insurance until age 26.

Also gone: the protections for those who have pre-existing medical conditions, though a few states like Minnesota may still have some state-level safeguards in place. Before the ACA, insurers on the individual market -- which serves people who don't have insurance through their jobs or a public program such as Medicare -- didn't have to cover people with asthma, diabetes, cancer or myriad other conditions. Returning to an era when sick people were priced out of coverage or barred by insurers from buying it is unacceptable.

The same holds true for rolling back the historic coverage gains made under the ACA. In Minnesota, repealing the entire law without replacing it would result in about 335,000 people losing coverage, according to a 2017 estimate by respected health care wonk Charles Gaba. In Wisconsin, the tally is 165,000. In North Dakota, 34,000. In South Dakota, about 21,000.

Those aren't just numbers. Those are Midwestern families and friends whose access to care could be in jeopardy. To our North Dakota, South Dakota and Wisconsin neighbors, you deserve better than an attorney general whose time is spent on this vain, harmful pursuit.